Acetabular Labral Tear, Hip Impingement Syndrome
Conditions
Brief summary
This study is being proposed to examine weight bearing precautions following hip arthroscopic labral repair, femoroplasty, and capsular closure. Standard post operative protocols limit weight bearing for 2-6 weeks depending on individual surgeons. Cadaveric studies demonstrate that minimal force during weight bearing is distributed through labrum. Therefore, progressing weight bearing earlier in these patients post operatively may help progress faster and improve outcomes. Data collected will include demographic information, radiological data, operative procedures and PRO data.
Detailed description
The study will be conducted at UPMC St. Margaret's Hip Preservation Program. Consented patients who undergo acetabular labral repair and femoroplasty will be included in randomization of weight-bearing status. Two separate protocols will be created to indicate weight bearing status, either WBAT immediately post-op or FFWB immediately post-op, to distribute to rehabilitation staff to ensure compliance. Immediately after the surgical procedure, the surgeon will be blinded and a randomized pamphlet with post-operative instructions with weight bearing education will be given to PACU nursing staff to educate patients and fit crutches.
Interventions
OTHERWeight Bearing as tolerated (WBAT) immediately following surgery.
Subject will be provided standard of care physical therapy following surgical intervention, except will be able to self-select weight bearing based on pain and confidence.
OTHERFlat foot weight bearing (FFWB) immediately following surgery
Subject will be provided standard of care physcial therapy following surgical intervention except
Sponsors
University of Pittsburgh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Caregiver, Outcomes Assessor)
Masking description
Physician performing surgical intervention will be blinded from surgery until first follow up. Also, physician performing ultrasound evaluation of hip capsule will remain blinded to weight bearing designation.
Intervention model description
Subjects will be enrolled into either Weight bearing as tolerated group immediately or Flat foot weight bearing group for 2 weeks. Currently, flat foot weight bearing for the first 2 weeks is standard of care.
Eligibility
Sex/Gender
ALL
Age
12 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age\>= 12 years * Diagnoses: femoroacetabular impingement and hip labral tears. * Surgical procedures performed: Hip arthroscopy with femoroplasty and labral repair. * Surgery completed at UPMC Children's or UPMC St. Margaret's Hospital * unilateral and bilateral hip patients
Exclusion criteria
* MSK tumor-related FAI or dysplasia * generalized hypermobility * revision surgeries
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| International Hip Outcome Tool 12 (iHot-12) | up to 6 months post-operative | Scoring ranges from 0-100 * each question is rated from 0-100 and final score is the mean of all questions answered by subject * higher scoring indicating higher quality of life due to hip function |
| Hip and Groin Outcome Score (HAGOS) | up to 6 months post-operative | This outcome includes 6 subscales, these are scored independently, and no aggregate scoring is calculated as each section assesses different dimensions separately. Subscales (raw scores for each subscale converted to a 0-100 scale with higher score indicating higher level of function): * Pain * Symptoms * Activities of Daily Life * Function in Sport and recreation * Participation in Physical Activities * hip and groin-related quality of life |
| Hip Outcome Score (HOS) ADL | up to 6 months post-operative | Outcome assessing function with activities of daily living. Higher score is given for higher level of function and lower score indicating reduced function. 0-68 aggregate scoring converted to 0-100 scale. |
| Hip Outcome Score (HOS) Sport | up to 6 months post-operative | Outcome assessing function/difficulty completing dynamic activities associated with sports participation. Higher score is given for higher level of function and lower score indicating reduced function. 0-36 aggregate scoring converted to 0-100 scale. |
| Tampa Scale for Kinesiophobia-11 | up to 6 months post-operative | Outcome measure assessing fear of pain with movement. Scores range from 11 to 44. Higher scores indicate greater fear of movement |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Isometric strength measures hip add, abd, ER, and extension | 6-week, 3 months, and 6-month post-operative | Strength measures will be taken isometrically at post-operative follow ups. |
| Diagnostic ultrasound assessment of bilateral anterior hip capsule thickness | 3 months post-operative | Physician while blinded will perform ultrasound evaluation of the hip capsule to ensure healing. Ultrasound will measure the following: 1.Assess the bilateral hip anterior capsule in all patients, assessing for internal consistency or changes in capsular thickness from side to side. Normal hip capsular thickness has been reported as 7-8 mm, dysplastic hips range 3.2 +/- 0.5 mm, and femoroacetabular impingement subjects 4.7 +/- 0.6 mm. |
| Diagnostic ultrasound assessment of incision widening | 3 months post-operative | Physician while blinded will perform ultrasound evaluation of the hip capsule to ensure healing. 1\. Evaluation of capsular incision widening, cyst, attenuation and thinning from established norms. Normal hip capsular thickness has been reported as 7-8 mm, dysplastic hips range 3.2 +/- 0.5 mm, and femoroacetabular impingement subjects 4.7 +/- 0.6 mm |
| Diagnostic ultrasound for focal echogenic adhesions | 3 months post-operative | Physician while blinded will perform ultrasound evaluation of the hip capsule to ensure healing. 1\. Evaluate for focal echogenic adhesions or dyskinetic motion between capsule and overlying iliopsoas complex with activation of hip flexion. |
Countries
United States
Outcome results
None listed